Healthcare Provider Details

I. General information

NPI: 1851586556
Provider Name (Legal Business Name): JENNIFER JEAN PEDLEY DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER JEAN PEDLEY DC

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 08/31/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 EAST REDLANDS BLVD STE U
REDLANDS CA
92373-5541
US

IV. Provider business mailing address

940 FLORENCE RD
LIVERMORE CA
94550-5541
US

V. Phone/Fax

Practice location:
  • Phone: 909-353-9348
  • Fax:
Mailing address:
  • Phone: 312-218-1358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number038010539
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number3977
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number010597
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number31467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: